NCQA/MBHO Accreditation Requirements. The Contractor shall demonstrate to the Department its compliance with NCQA/MBHO accreditation requirements by meeting the following standards: A. The availability of behavioral healthcare practitioners and providers within its network; B. The development of preventive behavioral health programs; C. The development of Self-Management Tools for Use by Members; D. The establishment of a Complex Case Management Program that addresses the needs of adults with SMI, children with SED and other high risk groups with co-occurring conditions; E. The adoption of Clinical Practice Guidelines specific to the needs of behavioral health clients; F. The establishment of a process for Data Collection and Integration between the Contractor and the MBHO; G. Identify and report to DBHDID on critical Performance Measures that are specific to behavioral health members; H. Establish a written program description for the MBHO’s Utilization Management Program; I. Establish a process for collaboration between behavioral healthcare and medical care.
Appears in 2 contracts
Samples: Medicaid Managed Care Contract, Medicaid Managed Care Contract
NCQA/MBHO Accreditation Requirements. The Contractor shall demonstrate to the Department its compliance with NCQA/MBHO accreditation requirements by meeting the following standards:
A. The availability of behavioral healthcare practitioners and providers within its network;
B. The development of preventive behavioral health programs;
C. The development of Self-Management Tools for Use by Members;
D. The establishment of a Complex Case Management Program that addresses the needs of adults with SMI, children with SED and other high risk groups with co-occurring conditions;
E. The adoption of Clinical Practice Guidelines specific to the needs of behavioral health clients;
F. The establishment of a process for Data Collection and Integration between the Contractor and the MBHO;
G. Identify and report to DBHDID on critical Performance Measures that are specific to behavioral health members;
H. Establish a written program description for the MBHO’s Utilization Management Program;
I. Establish a process for collaboration between behavioral healthcare and medical care.healthcare
Appears in 2 contracts
Samples: Medicaid Managed Care Contract, Medicaid Managed Care Contract
NCQA/MBHO Accreditation Requirements. The Contractor shall demonstrate to the Department DBHDID its compliance with NCQA/MBHO accreditation requirements by meeting having met the following standards:
A. The availability of behavioral healthcare practitioners and providers within its network;
B. The development of preventive behavioral health programs;
C. The development of Self-Management Tools for Use by Members;
D. The establishment of a Complex Case Management Program that addresses the needs of adults with SMIserious mental illness, children with SED serious emotional disturbances and other high risk groups with co-occurring conditions;
E. The adoption of Clinical Practice Guidelines specific to the needs of behavioral health clients;
F. The establishment of a process for Data Collection and Integration between the Contractor and the MBHO;
G. Identify and report to DBHDID on critical Performance Measures that are specific to behavioral health members;
H. Establish a written program description for the MBHO’s Utilization Management Program;
I. Establish a process for collaboration between behavioral healthcare and medical care.
Appears in 1 contract
Samples: Managed Care Contract (Wellcare Health Plans, Inc.)
